A Retrospective Crossover Study on Cross-Linked Hyaluronic Acid Gel (Lacrifill) Versus Cyclosporine A 0.05% (Restasis) for Dry Eye Disease
Bibliographic record
Abstract
PURPOSE: This retrospective crossover study compares two-month outcomes of cyclosporine A ophthalmic emulsion 0.05% (Restasis) versus cross-linked hyaluronic acid gel (Lacrifill), a novel canalicular occlusive device, in 20 patients with refractory aqueous-deficient dry eye disease (DED) at a rural optometry clinic. METHODS: In patients with moderate to severe DED, two-month outcomes for Restasis and Lacrifill (after a washout period) were compared using tear breakup time (TBUT), Schirmer scores, corneal staining (Efron scale), and Ocular Surface Disease Index (OSDI) scores. Paired t-tests or Wilcoxon signed-rank tests were used (p<0.05), with strict adherence to ethical compliance. RESULTS: Both treatments improved TBUT, Schirmer scores, corneal staining, and OSDI from baseline (p<0.001). Lacrifill outperformed Restasis: TBUT (+2.28 vs. +1.30 s, p<0.001), Schirmer (+2.33 vs. +1.08 mm, p=0.001), staining (-1.03 vs. -0.55 grade, p=0.003), and OSDI (-33.33 vs. -10.83 points, p<0.001). Eye-level analyses (N=40) confirmed these findings, with no age or sex associations (p>0.05). CONCLUSION: Lacrifill provided superior tear retention and symptom relief during the first two months of treatment compared to Restasis in refractory aqueous-deficient DED, supporting occlusion therapies in DED management. Larger prospective trials are needed to confirm efficacy and explore the use of combination therapies (typically three to six months).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".